Both companies have partnered with GE, Philips, Siemens and Toshiba as part of their cath lab installation packages.
Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice
To use IVUS, physicians use a guide wire, usually 0. Angiography is used to guide the IVUS catheter to the area of the vessel to be imaged. It is placed farthest away from the area to be imaged and is then pulled back through the area of stenosis.
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The IVUS catheters use either a fixed array of mini transducers, or a single rotating transducer. IVUS has several advantages over traditional angiography.
It can help better define vessels that are difficult to analyze using angiographic imaging, such as determining the lumen size of ostial lesions or areas with several overlapping vessels. Also, unlike angiography, it visualizes the atheroma and allows measurement of both the lumen and the plaque thickness on the arterial wall. Angiographs do not show remodeling of vessel walls, so the true extent of plaque buildup may not be evident.
IVUS allows a cross sectional view of the artery that can clearly show the intima, plaque deposits and the remodeled lumen. Millimeter marks can be superimposed on IVUS images to accurately measure the current lumen and the original lumen size to determine the amount of stenosis and to determine what size stent is needed if the vessel will undergo PCI.
The tool measures proximal and distal blood pressure around a lesion to help determine if an intervention is needed. IVUS is said to be one of the promising modalities to help identify vulnerable plaque.
The IVUS system can detect variations in sound waves reflected back to the transducer created by different materials in plaque being imaged. Using a method called virtual histology VH , an IVUS system can create a color-coded cross sectional image of a vessel showing the make-up of the plaque. Volcano said its proprietary VH IVUS technology helps differentiate the four plaque types: fibrous, fibro-fatty, necrotic core and dense calcium.
The cost-effectiveness of the routine use of IVUS during vascular procedures needs to be further studied.
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